APPENDIX I

(See Paragraph – 6)

FORM 1

(I) Basic Information

Sr.
Item Details
No.
1 Name of the Project Shikhar Avenue
2 S. No. in the Schedule 8(a)
3 Proposed capacity/ area/ length/ tonnage to Plot Area: 8711.00 m2
be handled/ command area/ lease area/ Built-up Area: 41446.78 m2
number of wells to be drilled
4 New/ Expansion/ Modernization New
5 Existing capacity/ Area etc. Not Applicable
6 Category of Project i.e. ‘A’ or ‘B’ B
7 Does it attract the general condition? If yes, No
please specify.
8 Does it attract the specific condition? If yes, No
please specify.
9 Location:
Plot/ Survey/ Khasra No. Survey No. 150/1, F.P. No. 43/1, O.P No
43/1 T.P.S. No. 99
Village Moje- Chiloda (Naroda)
Tehsil Gandhinagar
District Gandhinagar
State Gujarat
10 Nearest railway station/ airport along with Kalupur (Ahmedabad) Railway Station @
distance in km 11.40.0 km, WSW
S. V. P. International Airport, Ahmedabad
@ 3.1 km, WSW
11 Nearest Town, City, District Headquarters City/District: Ahmedabad @ 9.9 km, WSW
along with distance in km
12 Village panchayats, Zilla Parishad, Municipal Ahmedabad Municipal Corporation
Corporation, Local Body (Complete postal Naroda Muthia Ward Office, Naroda OR
addresses with telephone nos. to be given)
Mahanagar Seva Sadan, Sardar Patel
Bhavan, Danapith, Ahmedabad - 380001
Gujarat, India
Tel: +91-79-25391811 to 25391830
Fax: +91-79-25350926
13 Name of the applicant For Shikhar Avenu
Sr.
Item Details
No.
Kiritkumar Kantilal Patel
14 Registered Address Shikhar Avenue
Survey No. 150/1, F.P. No. 43/1, O.P No
43/1 T.P.S. No. 99, Moje- Chiloda (Naroda)
Ta- Gandhinagar, Dist- Gandhinagar.
15 Address for correspondence: Shikhar Avenue
Survey No. 150/1, F.P. No. 43/1, O.P No
43/1 T.P.S. No. 99, Moje- Chiloda (Naroda)
Ta- Gandhinagar, Dist- Gandhinagar.
Name Kiritkumar Kantilal Patel
Designation (Owner/ Partner/ CEO) Partner
Address 12, Ashray Bunglows, B/H Maniba School,
Sardar Chowk, Krushnanagar, Ahmedabad.
Pin Code 382345
E-mail shikharavenue.env@gmail.com
Telephone No. Mo. No. 9879475988
Fax No. ---
16 Details of Alternative Sites examined, if any. None
Location of these sites should be shown on a
topo sheet
17 Interlinked Projects None
18 Whether separate application of interlinked Not Applicable
project has been submitted?
19 If Yes, date of submission Not Applicable
20 If No, Reason Not Applicable
21 Whether the proposal involves approval/ No
clearance under:
(a) The Forest (Conservation) Act, 1980?
(b) The Wildlife (Protection) Act, 1972?
(c) The C.R.Z Notification, 1991?
If yes, details of the same and their status to
be given.
22 Whether there is any Government Order/ No
Policy relevant/ related to the site?
23 Forest land involved (Hectare) No
24 Whether there is any litigation pending No
against the project and/or land in which the
project is propose to be setup?
(a) Name of the Court
(b) Case No.
Sr.
Item Details
No.
(c) Orders/ Directions of the Court, if any
and its relevance with the proposed project.

(II) Activity

1 Construction, operation or decommissioning of the Project involving actions, which will

cause physical changes in the locality (topography, land use, changes in water bodies,
etc.)
Details thereof (with approximate
Sr. Yes/
Information/ Checklist Confirmation quantities / rates, wherever possible) with
No. No
source of information data
1.1 Permanent or temporary change in Yes Change in the topography of land during the
land use, land cover or topography construction activities (Excavation for
including increase in intensity of land Proposed Built up area) of proposed project
use (with respect to local land use and it will be a permanent effect due to
plan) proposed construction activity. However,
the same will not crate any adverse impact
on the environment.
1.2 Clearance of existing land, vegetation No Not Applicable due to the fact that the
and buildings? proposed project will be developed on an
open land area.
1.3 Creation of new land uses? Yes The land area of Survey No. 150/1, F.P. No.
43/1, O.P No 43/1 T.P.S. No. 99 is allotted to
Shikhar Avenue for the development of new
residential + commercial buildings.
1.4 Pre-construction investigations e.g. Yes Soil testing has been done. Soil testing
bore houses, soil testing? report attached as Annexure – 12.
1.5 Construction works? Yes There will be construction of new
residential + commercial buildings named
“Shikhar Avenue” developed by Shivam
Buildcon.
(Total Built-up area: 41446.78 m2
Residential Apartments: 112 Nos. &
Commercial Offices: 208 Nos)
1.6 Demolition works? No Not Applicable
1.7 Temporary sites used for No The construction works will be done by the
construction works or housing of workers from the nearby area and hence
construction workers? there will be no need for temporary housing
of construction workers.
1.8 Above ground buildings, structures Yes The proposed project of residential +
or earthworks including linear commercial building development includes
structures, cut and fill or excavations above & below ground structures. Hence,
excavation will be required. Please refer the
drawings attached for more details.
1.9 Underground works including mining
or tunneling?
1.10 Reclamation works?
1.11 Dredging?
1.12 Offshore structures?
1.13 Production and manufacturing
processes?
1.14 Facilities for storage of goods or
materials?
1.15 Facilities for treatment or disposal of
solid waste or liquid effluents?
1.16 Facilities for long term housing of
operational workers?
1.17 New road, rail or sea traffic during
construction or operation?
1.18 New road, rail, air waterborne or
other transport infrastructure
including new or altered routes and
stations, ports, airports etc?
1.19 Closure or diversion of existing
No Not Required
No Not Required
No Not Required
No Not Required
No Not Applicable
Yes Construction Phase:
Minimum bulk material for construction will
be bought as and when required and will be
temporarily stored at site with proper
arrangement of storage and under proper
coverage.
Yes Solid Wastes:
Solid waste generated in Project area will
be mainly of domestic nature. The solid
wastes generation in the construction phase
will be 20 kg/day and will be stored in
municipal bins before it’s’ collection by
AMC. While the solid waste generation in
the operation phase will be 710 kg/day and
the same will be collected & stored in the
community bins from where it will be
collected by the AMC.
Please refer Annexure – 5 for more details.
Liquid Effluent:
On site sanitation facilities will be provided
for proper disposal of liquid effluent @ 4.0
KLD during the construction phase which
will be disposed off through the septic
tank/soak pit system.
The total domestic wastewater generation
during the operation phase will be 155.20
KLD which will be disposed off in to the
AMC under drainage line.
Please refer Annexure v- 4 for more details.
No Workers & staff will be recruited from the
nearby areas.
No The existing road network will be adequate
for the additional traffic load.
No Not envisaged
No Not Required
 transport routes or infrastructure
leading to changes in traffic
movements?
1.20 New or diverted transmission lines or No Not Required
pipelines?
1.21 Impoundment, damming, culverting, No There will not be any changes occurred to
realignment or other changes to the the hydrology of watercourses or aquifers
hydrology of watercourses or due to the proposed project.
aquifers?
1.22 Stream crossings? No Not Applicable
1.23 Abstraction or transfers of water No Construction Phase:
form ground or surface waters? During a construction phase the fresh water
requirement 13.00 KLD will be met by bore
well water.
Operation Phase:
During an operation phase the total fresh
water requirement of 201 KLD will be met
by AMC water supply / bore well (stand-by).
1.24 Changes in water bodies or the land No Not Applicable
surface affecting drainage or run-off?
1.25 Transport of personnel or materials Yes Transportation of personal/materials will be
for construction, operation or required in both construction and operation
decommissioning? phases. However, it will be transported by
the existing road facilities.
1.26 Long-term dismantling or No Not Required
decommissioning or restoration
works?
1.27 Ongoing activity during No Not Applicable
decommissioning which could have
an impact on the environment?
1.28 Influx of people to an area in either Yes During the construction phase, 100 workers
temporarily or permanently? will be employed temporarily and hired
from nearby local areas.
During the operation phase, there will be
influx of more than 3680 (560 permanent
residents, 2120 commercial and 1000
visitors) people.
1.29 Introduction of alien species? No Not Applicable
1.30 Loss of native species or genetic No Not Applicable
diversity?
1.31 Any other actions? No None

2. Use of natural resources for construction or operation of the Project (such as land, water,
materials or energy, especially any resources which are not-renewable or in short supply)
 Details thereof(with approximate
Sr. Yes/
Information/Checklist confirmation quantities/rate, wherever possible) with
No. No
source of information data
2.1 Land especially undeveloped or No The total land area of proposed project site
agricultural land (ha) is 0.8711 ha. which is already converted into
non-agricultural land.
2.2 Water (Expected source & competing Yes Water requirement will be as follows:
users) Unit: KLD Construction phase
Maximum Quantity: 13.0 KLD
Source: Bore well
Operation phase
Maximum Quantity: 201.00 KLD
Source: AMC water supply / Bore well
(Standby)

Details of water consumption during

construction and operation phases are
elaborated in Annexure – 4.
2.3 Minerals (MT) No Not Applicable
2.4 Construction material – stone, Yes Construction materials such as stone,
aggregates, and/ soil (expected cement, sand, bricks, marble, paints, tiles,
source – MT) electric ware, sanitary ware, glass will be
used. All the above materials will be
purchased from the local market and from
nearest approved quarries, as and when
required. It will be stored temporarily at the
site. Approximate quantity are as follows:
Sr.
Material Quantity
No.
1. Steel (t) 880
2. Cement (bags) 184874
3. Stone Aggregate (m3) 30098
4. Sand (m3) 82110
5. Bricks (m3) 710
6. Glass (m2) 5265
Fly Ash Based Products
7. 2030
(m3)
2.5 Forests & Timber (sources – MT) Yes Wood will be required in small quantity for
doors, windows, furniture etc. for the
proposed project.
2.6 Energy including electricity & fuels Yes Construction Phase:
(sources/competing users) Units: Requirement – 21.0 KVA
Fuel (MT) & Energy (MW) Source – Torrent Power
Operation Phase:
Requirement – 960.0 KVA
Source – Torrent Power

2.7 Any other natural resources No Not Applicable

 (appropriate standard units)

3. Use, storage, transport, handling or production of substances or materials, which would

be harmful to human health or the environment or raise certain about actual or
perceived risks to human health.
Details thereof(with approximate
Sr. yes/
Information/Checklist Confirmation quantities/rate, wherever possible) with
No. No
source of information data
3.1 Use of substances or materials, No Not Applicable
which are hazardous (as per MSIHC
rules) to human health or the
environment (flora, fauna, and water
supplies)
3.2 Changes in occurrence of disease or No Not Applicable
affect disease vectors (e.g. insect or
water borne diseases)
3.3 Affect the welfare of people e.g. by Yes During construction phase 100 workers will
changing living conditions? be employed temporarily from nearby
areas.
During the operational phase, there will be
influx of more than 3680 Nos. (560
Permanent Residents, 2120 Commercial &
1000 Visitors) people.
3.4 Vulnerable groups of people who No No such groups of people will be affected by
could be affected by the project e.g. the proposed project.
hospital patients, children, the
elderly etc.
3.5 Any other causes No None

4. Production of solid wastes during construction or operation or decommissioning

(MT/Month)
Details thereof(with approximate
Sr. Information / Checklist yes/
quantities/rate, wherever possible) with
No. Confirmation No
source of information data
4.1 Spoil, overburden or mine wastes No Not Applicable
4.2 Municipal waste (domestic and or Yes The municipal solid wastes generated
commercial wastes) during operation phase will consist of:
Organic waste: Waste vegetables and foods
Inorganic waste: Papers, cartons,
Thermocol, plastics, polythene bags, Glass,
etc.
Solid waste storage location will be
incorporated in the design itself.
Adequate number of collection bins,
separately for biodegradable and non-
biodegradable waste will be provided as per
 Municipal Solid Waste (Management and
Handling) Rule, 2000. Waste from such bins
will be collected separately on daily basis.
The quantity of solid wastes generated will
be approximately 710 kg/day.
Please refer Annexure – 5 for more details.
4.3 Hazardous wastes (as per Hazardous No There will be no generation of any type of
Waste Management Rules) Hazardous waste.
4.4 Other industrial process wastes No Not Applicable
4.5 Surplus product No Not Applicable
4.6 Sewage sludge or other sludge from No Not Applicable
effluent treatment
4.7 Construction or demolition wastes No The Small quantity of construction waste
free from any hazardous content will be
generated and used for filling in a low-lying
area.
The construction waste will consist of
construction debris along with cement bags,
Unusable steel scrap (small cut-pieces of
steel), insulating and packaging materials
etc.
Cement bags, waste paper and cardboard
packing material will be sold off to
recyclers. Unusable steel scrap (small cut-
pieces of steel) will also be collected at site
and sold to recyclers.
4.8 Redundant machinery or equipment No Not Applicable
4.9 Contaminated soils or other No Not Applicable
materials
4.10 Agricultural wastes No Not Applicable
4.11 Other solid wastes No Not Applicable

5. Release of pollutants or any hazardous, toxic or noxious substances to air (Kg/hr)

Details thereof (with approximate
Sr. Information / Checklist Yes/
quantities/rate, wherever possible) with
No. Confirmation No
source of information data
5.1 Emissions from combustion of fossil No Not Applicable
fuels from stationary or mobile
sources
5.2 Emissions from production processes No Not Applicable
5.3 Emissions from materials handling Yes High levels of Suspended Particulate
including storage or transport Matters (SPM) may be noted due to various
construction activities & handling and
storage of construction materials. However,
continuous water sprinkling will be done
 and temporary windshield barriers will be
provided by the use of bamboos and GI
sheets to prevent the emissions.
5.4 Emissions from construction Yes Temporary emission of a very moderate
activities including plant and level of particulate matter is anticipated
equipment due to vehicular movement during the
construction phase. However, the entire
area will be sprinkled with water and rising
of greenbelt will be commenced
simultaneously with the project to minimize
emission levels.
At the time of transportation &
construction, dust will be generated.
Manually Water sprinkling will be carried
out to minimize dust suppression.
5.5 Dust or odours from handling of Yes Construction Phase:
materials including construction Dust will be generated during construction
materials, sewage and waste activity. Water sprinkling will be carried out
to minimize dust suppression. On site
sanitation facilities (septic tank and soak
pit) will be provided during the construction
phase. Temporary Solid waste storage will
be provided at site and recyclable material
will be sold to recyclers.
Operation Phase:
During the operational phase, sewage will
be disposed off in to AMC under drainage
line.
5.6 Emissions from incineration of waste No Not Applicable
5.7 Emissions from burning of waste in No No open burning will be carried out within
open air (e.g. slash materials, the premises.
construction debris)
5.8 Emissions from any other sources No Not Applicable

6. Generation of Noise and Vibration, and Emissions of Light and Heat

Details thereof (with approximate
Sr. Information / Checklist Yes/
quantities/rates, wherever possible) with
No. Confirmation No
source of information data
6.1 From operation of equipment e.g. Yes During construction, the machinery used for
engines, ventilation plant, crushers construction will be of high standard of
reputed make and will adhere to
International standards. These standards
 itself take care of noise pollution control/
vibration control and air emission control.
Hence, insignificant impacts due to
construction machinery are envisaged.
There won’t be any major source of noise
generation during the operation phase.
6.2 From industrial or similar processes No Not Applicable
6.3 From construction or demolition Yes Minor noise will be generated during the
construction work which will be temporary
and n the immediate vicinity of the project
site.
6.4 From blasting or piling No Not Applicable
6.5 From construction or operational Yes Noise will be generated due to construction
traffic as well as operational traffic; however the
quantum would be very marginal and may
happen for short period only.
6.6 From lighting or cooling systems Yes There will be minor chances of noise
generation from such types of equipment.
However, necessary care will be taken at
the time of equipment selection.
6.7 From any other sources No Not Applicable

7. Risk of contamination of land or water from releases of pollutants into the ground or into
sewers, surface waters, groundwater, coastal waters or the sea:
Details thereof(with approximate
Sr. Information / Checklist Yes/
quantities/rate, wherever possible) with
No. Confirmation No
source of information data
7.1 From handling, storage, use or No Not Applicable
spillage of hazardous materials
7.2 From discharge of sewage or other No Not applicable due to the fact that the
effluents to water or the land wastewater to be generated from proposed
(expected mode and place of project will be discharged in to the under
discharge) drainage line of Ahmedabad Municipal
Corporation (AMC).
7.3 By deposition of pollutants emitted No Not Applicable
to air into the land or into water
7.4 From any other sources No Not Applicable
7.5 Is there a risk of long term build up No Not Applicable
of pollutants in the environment
from these sources?

8. Risk of accidents during construction or operation of the Project, which could affect
human health or the environment
Details thereof (with approximate
Sr. Information / Checklist Yes/
quantities/rate, wherever possible) with
No. Confirmation No
source of information data
8.1 Form explosions, spillages, handling, No Not Applicable
use or production of hazardous
substances
8.2 From any other causes Yes During the Construction phase possibility of
accidents may be fall from height, scaffolds,
temporary stairs, cutting and welding,
electrical fitting etc
During the Operation phase possibility of
accidents may be electrical fire.
Please refer Annexure – 8 for more details.
8.3 Could the project be affected by Yes Project area is categorized in the seismic
natural disasters causing zone III, which is classified as having a
environmental damage (e.g. floods, moderate seismic intensity. The structure
earthquakes, landslides, cloudburst Design is as per Codes to negate the threat
etc)? of environmental and other damages by
natural disasters.

9. Factors which should be considered (such as consequential development) which could

lead to environmental effected or the potential for cumulative impacts with other
existing or planned activities in the locality.
Details thereof (with approximate
Sr. Information / Checklist Yes/
quantities/rates, wherever possible) with
No. Confirmation No
source of information data
9.1 Lead to development of supporting. Yes
Facilities, ancillary development or
development stimulated by the
project which could have impact on
the environment e.g.:
Supporting infrastructure (roads, Supporting infrastructure will be developed
power supply, waste or waste water like road, water supply network, power etc.
treatment, etc.),
housing development, Increase in demand for housing
extractive industries, Increase in demand in industrial facilities
supply industries, Increase in demand in supply industries
other Increase in demand for commercial and
recreational facilities
9.2 Lead to after-use of the site, which Yes Negligible increase in traffic and there will
could have an impact on the be positive impact on socio- economic
environment environment.
9.3 Set a precedent for later Yes The project will lead to development of a
developments residential flats & Commercial Shops.
9.4 Have cumulative effects due to No Not Applicable
proximity to other existing or
planned projects with similar effects

(III) Environmental Sensitivity

Sr. Name/ Arial distance (within 15 km) from
Areas
No. Identity proposed project location boundary
1. Areas protected under international None Not Applicable
conventions, national or local
legislation for their ecological,
landscape, cultural or other related
value
2. Areas which are important or sensitive River Sabarmati River @ 2.19 km, W
for ecological reasons – wetlands,
water courses or other water bodies,
coastal zone, biospheres, mountains,
forests
3. Areas used by protected, important or None Not Applicable
sensitive species of flora or fauna for
breeding, nesting, foraging, resting,
over wintering, migration
4. Inland, coastal, marine or underground None Not Applicable
waters
5. State, National boundaries None No state or national boundary falls
within 15 km from the project site.
6. Routes or facilities used by the public None Not Applicable
for access to recreation or other
tourist, pilgrim areas
7. Defense installations None Not Applicable
8. Densely populated or built-up area Ahmedabad The site is situated within the limits
City of Ahmedabad Municipal
Corporation.
9. Areas occupied by sensitive man-made Yes Hospitals, schools, institutes, places
land uses (hospitals, schools, places of of worship, community places etc.
worship, community facilities) are present. It may be noted that the
proposed project consists of
residential flats. Therefore, it would
not have any adverse impact on such
places.
10. Areas containing important, high No Not Applicable
quality or scarce resources (ground
water resources, surface resources,
forestry, agriculture, fisheries, tourism,
minerals)
11. Areas already subjected to pollution or No Not Applicable
environmental damage. (those where
existing legal environmental standards
are exceeded)
12. Areas susceptible to natural hazard No As per earthquake sensitivity index,
which could cause the project to the proposed project site is situated
present environmental problems in Zone – III having moderate
Sr. Name/ Arial distance (within 15 km) from
Areas
No. Identity proposed project location boundary
(earthquakes, subsidence, landslides, damage risk (MSK – VII) and
erosion, flooding or extreme or considering the same proposed
adverse climatic conditions) project will be designed. There is no
other threat for the natural hazard.
“I hereby given undertaking that the data and information given in the application and
enclosures are true to the best of my knowledge and I am aware that if any part of the data and
information submitted is found to be false or misleading at any stage, the project will be
rejected and clearance give, if any to the project will be resolved at our risks and cost.”

Date: 17/07/2017

Place: Krushnanagr, Ahmedabad Signature of the applicant

(Partner)
Kiritkumar Kantilal Patel

Address:12, Ashray Bunglows,

B/H Maniba School, Sardar chowk,
Krushnanagar, Ahmedabad.